Clinical Governance Clinical Governance

VTS Scheme PresentationVTS Scheme Presentation

Feb 2003 Feb 2003

Matt WalshMatt Walsh

Who am I?Who am I?

GPGP TrainerTrainer Bradford VTS ‘graduate’Bradford VTS ‘graduate’ S & W Bradford PCT Director for S & W Bradford PCT Director for

QualityQuality

Aims for the sessionAims for the session

To assess current levels of To assess current levels of understanding of clinical governanceunderstanding of clinical governance

To understand the history.To understand the history. To improve understanding of the To improve understanding of the

principles behind the concept of clinical principles behind the concept of clinical governancegovernance

To understand some of the tools.To understand some of the tools. To test some of the tools in a practical To test some of the tools in a practical

setting.setting.

What does it mean to What does it mean to you?you? What words do you think of?What words do you think of? How does it make you feel?How does it make you feel? What experience have you of What experience have you of

‘clinical governance?’‘clinical governance?’ Can you describe what ‘it’ is?Can you describe what ‘it’ is?

““A framework through which NHSA framework through which NHS

organisations are accountable fororganisations are accountable for

continually improving the qualitycontinually improving the quality

of their services and safeguardingof their services and safeguarding

high standards of care by creatinghigh standards of care by creating

an environment in which excellencean environment in which excellence

in clinical care will flourish”in clinical care will flourish”

Clinical Governance - a DefinitionClinical Governance - a Definition

Donaldson and ScallyDonaldson and Scally

““A framework through which NHSA framework through which NHS

organisationsorganisations are are accountableaccountable for for

continuallycontinually improving the qualityimproving the quality

of their services and safeguardingof their services and safeguarding

high standards of care by creatinghigh standards of care by creating

an an environmentenvironment in which excellence in which excellence

in clinical care will flourish”in clinical care will flourish”

Clinical Governance - a DefinitionClinical Governance - a Definition

Donaldson and ScallyDonaldson and Scally

OrganisationOrganisation

A group of persons organized for a A group of persons organized for a particular purpose; an association: particular purpose; an association: a benevolent organization.a benevolent organization.

– A structure through which A structure through which individuals cooperate individuals cooperate systematically to conduct systematically to conduct business. business.

– The administrative personnel of such The administrative personnel of such a structure. a structure.

AccountableAccountable

Liable to being called to account; Liable to being called to account; answerable. answerable.

EnvironmentEnvironment

The circumstances or conditions that The circumstances or conditions that surround one; surroundings. surround one; surroundings.

The totality of circumstances The totality of circumstances surrounding an organism or group of surrounding an organism or group of organisms, especially: organisms, especially:

The combination of external physical The combination of external physical conditions that affect and influence the conditions that affect and influence the growth, development, and survival of growth, development, and survival of organismsorganisms

The complex of social and cultural The complex of social and cultural conditions affecting the nature of an conditions affecting the nature of an individual or community. individual or community.

In other wordsIn other words

The practice (and therefore the The practice (and therefore the practitioner) will be called to practitioner) will be called to account and asked to account and asked to demonstrate on a regular basis demonstrate on a regular basis that the quality of care for its that the quality of care for its patients is continually patients is continually improving….. improving…..

In other wordsIn other words

……and to do this it will need to and to do this it will need to influence the complex of social influence the complex of social and cultural conditions affecting and cultural conditions affecting the nature of the individuals and the nature of the individuals and teams working with and for the teams working with and for the practice community. practice community.

QualityQuality

Define what it is that we are producing?

Produce it

Compare what we have produced with our standard.

Design and implement changes to production.

What is the role of the What is the role of the GP in this?GP in this? Duties of a doctor (GMC).Duties of a doctor (GMC). Good Medical Practice (GMC).Good Medical Practice (GMC). Good Medical Practice for GPs Good Medical Practice for GPs

(RCGP)(RCGP) Supporting Doctors, protecting Supporting Doctors, protecting

patients (DOH)patients (DOH)

The Duties of a Doctor.The Duties of a Doctor.(1)(1) make the care of your patient your first make the care of your patient your first

concern; concern; treat every patient politely and treat every patient politely and

considerately; considerately; respect patients' dignity and privacy; respect patients' dignity and privacy; listen to patients and respect their listen to patients and respect their

views; views; give patients information in a way they give patients information in a way they

can understand; can understand;

The Duties of a Doctor.The Duties of a Doctor.(2)(2) respect the rights of patients to be fully respect the rights of patients to be fully

involved in decisions about their care; involved in decisions about their care; keep your professional knowledge and keep your professional knowledge and

skills up to date; skills up to date; recognise the limits of your professional recognise the limits of your professional

competence; competence; be honest and trustworthy; be honest and trustworthy; respect and protect confidential respect and protect confidential

information; information;

The Duties of a Doctor.The Duties of a Doctor.(3)(3) make sure that your personal beliefs do make sure that your personal beliefs do

not prejudice your patients' care; not prejudice your patients' care; act quickly to protect patients from risk if act quickly to protect patients from risk if

you have good reason to believe that you you have good reason to believe that you or a colleague may not be fit to practise; or a colleague may not be fit to practise;

avoid abusing your position as a doctor; avoid abusing your position as a doctor; and and

work with colleagues in the ways that work with colleagues in the ways that best serve patients' interests. best serve patients' interests.

SWOT analysis for selfSWOT analysis for self

Think about why you get up for Think about why you get up for work in the morning. work in the morning.

Define a quality Define a quality framework for general framework for general practice.practice. ClinicalClinical UserUser InfrastructureInfrastructure StaffStaff

RulesRules

Safe environmentSafe environment Well chairedWell chaired Relevant information provided Relevant information provided

beforehandbeforehand About ‘I’ not about ‘you’, About ‘I’ not about ‘you’,

Potential outcomesPotential outcomes

CelebrateCelebrate No further actionNo further action More detailed auditMore detailed audit Change to strategy or training Change to strategy or training

planplan

Significant event auditSignificant event audit

‘‘where individual cases in which where individual cases in which there has been a significant there has been a significant occurrence, not necessarily involving occurrence, not necessarily involving an undesirable outcome for the an undesirable outcome for the patient are analysed in a systematic patient are analysed in a systematic way to ascertain what can be learned way to ascertain what can be learned about the overall quality of care and about the overall quality of care and to indicate changes which might lead to indicate changes which might lead to improvement’ to improvement’

Scenarios and Scenarios and feedbackfeedback

Clinical governanceClinical governance

Nothing newNothing new Opportunities and threatsOpportunities and threats Can support usCan support us Brings some resources with itBrings some resources with it Might make us feel betterMight make us feel better